The thoughts, semi-thoughts, splenetic rantings and vague half ideas, of a leftie-lib marooned in Palmerston North, New Zealand.

Tuesday, 9 October 2007

National's policy on Doctor's fees

Sitting in the waiting room of a medical centre, today, I gained a further insight into the reality of National's declared intention (1) of introducing competition to the medical sector by lifting the cap on doctor's fees.

Well over half an hour after my appointment, I got to see the doctor. This was no big deal, I was in no pain and I had nothing especially important to do with my time, such as work so I could pay the rent, so I could afford to wait. When we came out, people who had been waiting longer than us were still waiting. I'm sure some of them weren't as fortunate as I was.

If national win the election, they want to lift the cap on doctor's fees. John Key suggested the market would ensure that fees would not become excessive. If they did, the market would punish the doctors as their potential patients would "go down the road" (2).

Imagine what that would be like. Most people will try to see a doctor who pays less - those that can afford to go to see the doctor at all, that is. At that surgery, queues will be longer, waiting times will stretch out into hours. People taking time off work to attend the surgery will end up paying more because of hours lost waiting to be seen - but since you can't predict how long you'll have to wait, you'll have no way of knowing.

Those that can afford higher fees, meanwhile, be able to waltz into a waiting room that is sparsely populated and will receive prompt attention. Introducing competition will create what is, in effect, a two-tier health system. good quick service for some, a dismal standard for everyone else.

John Key is smart enough to know this. His claim that people will be able to "go down the road" is only part of the National vision. More fully, he is saying that people will be able to go down the road, and wait for tedious - perhaps painful - hours in an uncomfortable waiting room, long after those who can afford to pay higher fees have seen their doctor and gone home.

He will also know that for those at the bottom end of the experience, going "up the road" (3) isn't an option. They can't afford it. They are stuck with what they can pay for. Nor can they decide to do without.